Corneal Stromal Regeneration Seems Possible In Patients With Keratoconus

To investigate the increase in vision and central corneal thickness after intrastromal fresh myopic lenticule implantation in advanced keratoconus with SMILE and to examine the lenticule piece taken 3 years after lenticule implantation with both immunofluorescence and electron microscopy.

EYE HOSPITAL,PRISTINA,KOSOVO

Patient and SurgicalTechnical

21-year-old female patient with advanced keratoconus who was indicated for penetrating keratoplasty. The central corneal thickness in the right eye was 380 µm, UNDVA:0,1, CDVA:0.2,to:14 mm hg. Left eye CCT,504 µm, UDVA:1.0,to:15 mm hg.

Method

SMILE MODULE

The low vacuum was applied so that the patient could see the fixation light during docking,2,5-mm incision, and an Intrastromal pocket of 7.70mm. The optic zone is 6.50 mm, Cap thickness of 130 µm. Femtosecond laser (spot energy 130 nJ). A 120 µm-thickness fresh lenticule was implanted in the patient.

Results

The lenticule piece taken 3 years after its implantation was examined under electron microscopy and immunofluorescence, showing well-organized parallel lamellar structures. Healthy keratocytes and telocytes cells were observed. Thus, telocyte cells can be activated by appropriate stimuli such as stem cells, and be involved in stromal regeneration.

We are at the beginning of a long way to evaluate the effectiveness of this technique in a larger population sample. Yet, at present, fresh myopic intrastromal lenticular implantation is a safe, economical (it does not require laboratory support), and reliable technique that leads to increased corneal thickness; improved VA, as demonstrated in the literature; and the regeneration of the corneal tissue.

NCT04591587